Miami CFAR Symposium Highlights Breakthroughs in HIV Treatment, Cure Research and Community Impact
From long‑acting antiretroviral therapies and cure‑strategy research to implementation science and community‑centered care, the University of Miami CFAR symposium explored how HIV research is shaping the future of prevention and treatment.
From long‑acting antiretroviral therapies to emerging cure strategies and community‑centered implementation science, this year’s University of Miami Center for AIDS Research (CFAR) symposium, “HIV: Managing Today, Curing Tomorrow,” examined how far the HIV field has come and what it will take to ensure its most powerful advances reach those who need them most.
“The title of the meeting pretty much sums up where we are in the HIV field,” said Mario Stevenson, Ph.D., professor in the Division of Infectious Diseases at the University of Miami Miller School of Medicine and CFAR co-director. “The field has come a long way since the early days, with amazing medications that now offer the promise of twice‑yearly dosing.”
“It’s a particularly interesting time in the field, an exciting time,” said Rana Chakraborty, M.D., chief of the Division of Pediatric Infectious Diseases at the Miller School and director of CFAR. There’s a lot of work investigating a cure. Implementation science is also emerging. We’re doing significant work, globally, in terms of prevention efforts.”
Broadly Neutralizing Antibodies Point to Vaccine‑Like Prevention
In his CFAR symposium presentation, Ronald Desrosiers, Ph.D., professor of pathology and laboratory medicine and vice chair of basic research at the Miller School, outlined a long-term strategy for HIV prevention and treatment based on single-day, vector-mediated delivery of broadly neutralizing antibodies (bnAbs).
His laboratory has focused on adeno-associated virus (AAV)–based delivery of bnAbs, which offer the potential for sustained antibody expression when the expressed proteins are not perceived as foreign by the immune system. AAV-mediated gene therapy may offer a one-time administration route for lifelong antibody production.
He highlighted a landmark preclinical example in which a single day of AAV administration delivering multiple bnAbs led to durable viral suppression below the limit of detection for more than eight years, with antibody levels far exceeding therapeutic thresholds.
“This approach could be used for vaccine-like prevention of infection in humans and create the vaccine that’s been missing for all this period of time,” Dr. Desrosiers said.
Tracking HIV Through Wastewater‑Based Epidemiology
UM College of Engineering professor Helena Solo-Gabriele, Ph.D., detailed a large, multi-institutional effort using wastewater-based epidemiology to track infectious diseases at the population level, with particular emphasis on COVID-19 and future applications to HIV. The work integrates environmental wastewater data with human clinical data to provide early indicators of disease spread.
Wastewater acts as a community-wide reservoir of health information, capturing signals from respiratory, gastrointestinal, skin, viral, bacterial and fungal pathogens. During the COVID-19 pandemic, wastewater measurements consistently anticipated clinical trends and enabled early identification of emerging variants such as Delta.
“The application of wastewater to track many types of diseases, including respiratory disease, is new. We need to take advantage of it,” Dr. Solo-Gabriele said. “It provides a lot of additional information beyond the clinical data.”
Dr. Solo-Gabriele underscored the relevance of wastewater epidemiology to HIV surveillance, noting that both untreated and treated individuals shed detectable HIV genetic material. This opens the possibility of identifying undiagnosed populations, monitoring intervention effectiveness and detecting co-occurring infections.
“SARS-CoV-2 is an RNA virus. HIV is an RNA virus,” she said. “The understanding of HIV in order to apply it to SARS-CoV-2 was a huge resource for us.”
Addressing Aging, Brain Health and Long‑Term Complications of HIV
Modern antiretroviral therapy can suppress the virus to undetectable levels in most patients, dramatically extending life expectancy and reducing transmission. However, presenters underscored persistent challenges.
Steve Deeks, M.D., from the University of California, San Francisco, argued that, while antiretroviral therapy has transformed HIV into a manageable chronic condition, the field has reached an inflection point. Deeper biological and clinical challenges must be addressed to achieve durable remission or cure.
“Even after years of effective antiretroviral therapy, many individuals continue to experience persistent immune activation and inflammation,” Dr. Deeks said. “Suppressing the virus is necessary, but it is clearly not sufficient to restore health in people living with HIV.”
HIV infection accelerates aging-related conditions, including cardiovascular disease, neurocognitive decline and frailty, even among individuals with consistent viral suppression. Dr. Deeks underscored that these outcomes reflect not ongoing viral replication, but long-lasting immune system damage established early in infection and incompletely reversed by antiretroviral therapy.
Scott Letendre, M.D., from the University of California, San Diego, addressed the central nervous system as a critical HIV reservoir. HIV crosses the blood–brain barrier early in infection and persists in the brain through infection of immune cells. Even when antiretroviral therapy suppresses viral replication, viral transcription, translation and immune activation can continue, and dynamics vary from person to person.
“Even though we have amazing medications, about 30 to 35 percent of people who are on these medications still show neurocognitive defects,” Dr. Stevenson noted.
Dr. Letendre said some individuals show spontaneous control of HIV in the central nervous system. Others exhibit virus compartmentalization that may be resistant to interventions targeting peripheral reservoirs alone. Cell-associated HIV DNA and RNA in the central nervous system are linked to worse cognitive outcomes, reinforcing its clinical relevance.
Ultimately, brain health in people with HIV is shaped by multiple converging factors, including immune activation, co-infections, host vulnerability and aging-related mechanisms like endogenous retrotransposons. He concluded by stressing that future cure and treatment strategies must consider the central nervous system.
“The interventions we’re using should be able to distribute into the central nervous system,” he said.
Implementation Science and Community Partnerships Drive Impact
While the symposium showcased the success of current HIV therapies, viral suppression does not mean disease extinction.
“Unfortunately, these medications don’t cure,” Dr. Stevenson said. “The next frontier is to eradicate the infection.”
A central focus of Romas Geleziunas, Ph.D., vice president of research virology at Gilead Sciences, was what he called it a “kick‑and‑kill” problem. Latent HIV reservoirs must first be activated and then eliminated. Preclinical data shows that using a novel CD4‑targeted IL‑15 latency‑reversal agent to activate HIV‑infected CD4 T cells could induce viral expression, reduce proviral reservoirs in lymph nodes and delay viral rebound when combined with broadly neutralizing antibodies.
“A cure strategy has to be durable,” he said. “It cannot be temporary, where people rebound anytime.”
Sheree Schwartz, Ph.D., M.P.H., from the Johns Hopkins Bloomberg School of Public Health, examined how the pace of research translation affects the impact of HIV prevention and care. She framed implementation science as a critical tool for closing this gap but cautioned that speed must be applied thoughtfully.
“If we go too fast and skip steps, your failures can be unclear,” Dr. Schwartz said. “However, if we go too slow, this leads to unnecessary delays, and particularly delays in access.”
Community engagement emerged as a cross‑cutting theme. The symposium concluded with a panel discussion, “Florida Stories,” that brought together researchers, clinicians, public health leaders and community advocates to examine how community‑centered approaches can improve HIV prevention, treatment, retention in care and research participation.
Panelists:
- Moderator Allan Rodriguez, Ph.D., from the Miller School’s Division of Infectious Diseases
- Mariana Baum, Ph.D., RD, from Florida International University
- Lisa Sanders, M.D., from the University of South Florida
- Joel Yap Santana from the Florida Department of Health
- Melvin Fort from the Care Resource Community Health Center
- Sandra Anderson, Ed.D. from the Florida Department of Health and founder of ROAR (Raising Ongoing Adherence and Resilience)
Across disciplines and settings, panelists said relationships are the foundation of effective HIV prevention, care and research. Whether through long‑term research cohorts, youth advisory boards, peer support groups or trusted community intermediaries, success depends on meeting people where they are, culturally, emotionally and practically.
Poster Session Winners
• Basic Science: Shuanglin Hao, Ph.D., “Transcriptional Factor cMyc Plays an Important Role in Neuropathic Pain Induced by HIV Glycoprotein 120 With Morphine”
• Behavioral Science: Yue Pan, Ph.D., “Syndemic Burden Predicts Cardiovascular Risk Among Women With HIV
• Clinical Science: Enrique Lara, “Microbial AI‑2 Signaling as a Potential Biomarker of Vaginal Mucosal Vulnerability in Women With HIV”
• Implementation Science: Gisela Pires Foz de Barros, Ph.D., “Accelerating Care: Implementation of an HIV Rapid Start Initiative Into a Miami PrEP Fixed and Mobile Clinics Program”
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Tags: CFAR, Department of Pathology and Laboratory Medicine, Division of Infectious Diseases, Dr. Mario Stevenson, Dr. Rana Chakraborty, Dr. Ronald Desrosiers, gene therapy, HIV, HIV infection, HIV PrEP, HIV prevention, HIV/AIDS research, Infectious diseases, Miami Center for AIDS Research, pathology